Table 2

Molecular Characterization of Corynebacterium diphtheriae Outbreak Isolates, South Africa, March–June 2015

Mignon du Plessis

, Nicole Wolter, Mushal Allam, Linda de Gouveia, Fahima Moosa, Genevie Ntshoe, Lucille Blumberg, Cheryl Cohen, Marshagne Smith, Portia Mutevedzi, Juno Thomas, Valentino Horne, Prashini Moodley, Moherndran Archary, Yesholata Mahabeer, Saajida Mahomed, Warren Kuhn, Koleka Mlisana, Kerrigan McCarthy, and Anne von Gottberg

Author affiliations: National Health Laboratory Service, Johannesburg, South Africa (M. du Plessis, N. Wolter, M. Allam, L. de Gouveia, F. Moosa, G. Ntshoe, L. Blumberg, C. Cohen, M. Smith, P. Mutevedzi, J. Thomas, K. McCarthy, A. von Gottberg); University of the Witwatersrand, Johannesburg (M. du Plessis, N. Wolter, C. Cohen, A. von Gottberg); National Health Laboratory Service, Cape Town, South Africa (V. Horne); University of KwaZulu-Natal, Durban, South Africa (P. Moodley, M. Archary, Y. Mahabeer, S. Mahomed, W. Kuhn, K. Mlisana); National Health Laboratory Service, Durban (Y. Mahabeer, K. Mlisana); National Department of Health, KwaZulu-Natal, South Africa (W. Kuhn)

Main Article

Characteristics of patients and carriers who were Corynebacterium diphtheriae culture-positive, KwaZulu-Natal Province, South Africa, March–June 2015*

No.	Age, y	Isolate no.	Diagnosis	Vaccination status†	Outcome	Specimen type	Biotype	Elek	tox gene PCR	ST	CRISPR-Cas system (no. spacers)
1	8	45903	Respiratory diphtheria	Incomplete (missed 18 mo and 6 y boosters)	Died	Tonsillar swab	mitis	Pos	Pos	378	I-E-a (33)
2	8	45236	Respiratory diphtheria	Incomplete (missed 18 mo and 6 y boosters)	Survived	Throat swab	mitis	Pos	Pos	378	I-E-a (33)
3‡	9	45237	Respiratory diphtheria	Incomplete (missed 6 y booster)	Survived	Throat and nasal swabs	gravis	Neg	Neg	395	I-E-a (41), I-E-b (22)
3‡	9	45238	Respiratory diphtheria	Incomplete (missed 6 y booster)	Survived	Throat and nasal swabs	mitis	Pos	Pos	378	I-E-a (37)
4	31	45262	Cutaneous diphtheria	Unknown	Survived	Groin swab	gravis	Neg	Neg	395	I-E-a (28), I-E-b (21)
5	9	45902	Respiratory diphtheria§	Unknown	Survived	Tracheal aspirate	mitis	Pos	Pos	378	I-E-a (37)
6	5	45463	Respiratory diphtheria§	Unknown	Survived	Tracheal aspirate	gravis	Pos	Pos	378	I-E-a (37)
7	8	45461	Carrier§	Unknown	Survived	Throat swab	gravis	Pos	Pos	378	I-E-a (37)
8	1	45462	Carrier§	Unknown	Survived	Throat swab	mitis	Pos	Pos	378	I-E-a (37)
9	41	45464	Respiratory diphtheria	Unknown	Died	Throat swab	mitis	Pos	Pos	378	I-E-a (33)
10	17	45465	Respiratory diphtheria	Incomplete (missed 12 y booster)	Survived	Throat swab	mitis	Pos	Pos	378	I-E-a (37)
11	13	45466	Respiratory diphtheria	Incomplete (missed 18 mo, 6 y, and 12 y boosters)	Died	Tonsillar swab	mitis	Pos	Pos	378	I-E-a (37)
12	21	45785	Respiratory diphtheria	Unknown	Survived	Throat and nasal swabs	mitis	Pos	Pos	378	I-E-a (34)
13	6	45786	Carrier¶	Unknown	Survived	Throat and nasal swabs	mitis	Pos	Pos	378	I-E-a (33)
14	11	45784	Probable diphtheria	Up-to-date	Survived	Throat and nasal swabs	intermedius	Neg	Neg	395	I-E-a (38), I-E-b (21)
15	11	45789	Carrier#	Unknown	Survived	Throat and nasal swabs	mitis	Pos	Pos	378	I-E-a (31)
16	9	45790	Carrier#	Unknown	Survived	Throat and nasal swabs	mitis	Pos	Pos	378	I-E-a (31)
17	11	45791	Carrier#	Unknown	Survived	Throat and nasal swabs	mitis	Pos	Pos	378	I-E-a (31)
18	10	45792	Carrier#	Unknown	Survived	Throat and nasal swabs	gravis	Neg	Neg	395	I-E-a (42), I-E-b (22)
19	13	45787	Respiratory diphtheria**	Incomplete (missed 14 wk,18 mo, and 6 y boosters)	Survived	Throat swab	intermedius	Pos	Pos	378	I-E-a (35)
20	4	45788	Respiratory diphtheria**	Up-to-date	Survived	Throat swab	intermedius	Pos	Pos	378	I-E-a (35)

*CRISPR, clustered, regularly interspaced, short palindromic repeats; DTaP, diphtheria, tetanus, and pertussis; neg, negative; pos, positive; ST, sequence type.
†The Expanded Programme on Immunization in South Africa recommends DTaP vaccination at 6 weeks, 10 weeks, and 14 weeks with a booster at 18 months, and a tetanus-diphtheria booster at 6 years and 12 years (https://www.health-e.org.za/wp-content/uploads/2014/02/South-Africa-EPI-vaccines-revised-Oct-2010.pdf).
‡Two different genotypes were isolated from 1 patient during the same disease episode.
§Members of the same family.
¶Family member of a person who had respiratory diphtheria symptoms and died. The postmortem throat swab from this person was culture negative.
#Contact of patient 14.
**Members of the same family.

Main Article

Page created: July 17, 2017

Page updated: July 17, 2017

Page reviewed: July 17, 2017

The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

Volume 23, Number 8—August 2017

Research

Molecular Characterization of Corynebacterium diphtheriae Outbreak Isolates, South Africa, March–June 2015

Table 2